Impact of Cue-Based Feeding Protocol on Premature Infants\u27 Outcomes and Hospital Length of Stay

The project was an oral feeding practice change from traditional, gestational-age/volume-driven feeding progression to developmentally-based, infant-driven feeding progression. The infant-driven (cue-based) feeding protocol was implemented with goals to improve premature infants\u27 feeding outcomes, and decreased the infant\u27s length of hospitalization. The project was designed to implement a cue-based feeding protocol for oral feeding initiation and progression, within the neonatal intensive care unit (NICU) at Community Regional Medical Center (CRMC), and then retrospectively evaluate the impact of the cue-based feeding protocol on feeding outcomes. In order to realize full implementation of a NICU feeding practice change, multiple components, such as electronic charting, feeding policy, staff education and data reports, needed to be developed. Multiple unit- and hospital-level barriers prevented timely project implementation. Given the DNP program time constraints for project implementation, and the complex nature of project review and approval by nursing leadership, final, post-protocol data collection and analysis could not be completed. Delays in project implementation did not allow for oral feeding outcome evaluation, as originally proposed, however, the project did produce valuable instruments for recording and measuring feeding outcomes in the future. Future plans for project follow-up have been established by NICU nursing leadership. Data for 6-month and 1-year feeding outcomes will be collected and evaluated, with the intention to present results to: 1) CRMC corporate leadership, 2) CPQCC 1-year collaborative follow-up (June 2014); and 3) Central Valley Nursing Research Conference 2015

Multi-phase simulation of infected respiratory cloud transmission in air

In the face of the increasing death toll of the COVID-19 global pandemic, countries around the world have instituted restrictive measures to mitigate the serious effects of the pandemic. Human-to-human transmission of COVID-19 occurs primarily through large droplets that are expelled with sufficient momentum to come in direct contact with the recipients' mouth. Therefore, the physics of flow is central to transmission of COVID-19. Respiratory infections increase the frequency of violent expiration, including coughing and sneezing that are particularly effective in dispersing virus-carrying droplets. Moreover, the high viral load in droplets of asymptomatic hosts that are expelled during respiratory activities is contributing to the rapid growth of the COVID-19 global pandemic. The present study uses 2D smoothed-particle-hydrodynamics multi-phase simulations of the fluid dynamics of violent expiratory events in order to obtain a deeper understanding of the multi-phase nature of respiratory clouds, which can help determine separation distances from an infected person needed to minimize respiratory transmission. Our results indicate that there are three phases of jet cloud flow: the first is dominated by no-buoyancy jet-like dynamics characterized by a high speed, the second is dominated by negative buoyancy, and the third is dominated by gravity that deflects the cloud downward. Moreover, two modes of jet behavior that differ in dilution have been identified to be a function of distance from the human mouth. This work is of direct relevance to studies on the spread of COVID-19 and similar outbreaks in the future

Contrast enhanced ultrasound in the assessment of urogenital pathology

Contrast enhanced ultrasound (CEUS) is an innovative technique that employs microbubble contrast agents to demonstrate parenchymal perfusion. Although initial clinical application was focused on the liver pathology, a wide variety of clinical conditions can be assessed now with CEUS. CEUS is a well-tolerated technique and is acquiring an increasing role in the assessment of renal pathology because contrast agents are not excreted by the kidney and do not affect the renal function. CEUS demonstrated an accuracy similar to contrast enhanced multi-detector computed tomography (CEMDCT) in detecting focal lesions, with the advantage of the real-time assessment of microvascular perfusion by using time-intensity curves. The aim of this paper is to review the main indications of CEUS in the assessment of renal and urogenital pathology. Imaging examples are presented and described. Advantages and limitations of CEUS with reference to conventional US and CE-MDCT are discussed

Morphological adaptations for gut microbiota partitioning in the ant Cephalotes rohweri

Dissertação de Mestrado em Ecologia, apresentada ao Departamento de Ciências da Vida da Faculdade de Ciências e Tecnologia da Universidade de Coimbra.O fogo é um componente importante em muitos ecossistemas terrestres, essencial para entender a ecologia e diversidade de comunidades em regiões propensas ao fogo. O fogo produz impactos na fauna directamente, através de mortalidade, ou indirectamente, por mudanças na estrutura do habitat e disponibilidade de recursos (ex., alimento). Nas últimas décadas o aquecimento global, o abandono das terras e mudanças nas actividades tradicionais como agricultura, pastoreio ou gestão das florestas estão a mudar a frequência e a extensão dos fogos. Neste contexto, entender/ conhecer a resposta de organismos ao fogo é uma prioridade para a sua conservação. Os répteis são um bom grupo modelo para examinar o fogo pois são ectotérmicos, sensíveis a modificações na estrutura da vegetação, têm baixa mobilidade e taxas de dispersão, e enfrentam grandes taxas de declínio de populações e extinção. O objectivo deste estudo é avaliar os efeitos do fogo nas comunidades de répteis a duas escalas geográficas: a uma escala global, onde examinei os padrões das respostas dos répteis ao fogo, considerando o efeito do tempo desde o último incêndio (Capítulo 1); a uma escala local, onde avaliei o efeito dos fogos naturais nas comunidades de répteis do Parque Natural da Serra da Estrela, na riqueza de espécies e abundância de indivíduos (Capítulo 2) e examinei como é que a ecologia trófica e as interacções intra específicas variam com o fogo, usando a lagartixa Psammodromus algirus como espécie modelo (Capítulo 3). Para isto usei um conjunto de metodologias de maneira a recolher e analisar todos os dados necessários para realizar este estudo (recolha de artigos científicos para a análise global; transectos para a visualização de répteis seguidos da caracterização da vegetação e do habitat; analise de conteúdo fecal e redes ecológicas para a dieta das lagartixas). Os principais resultados deste trabalho demonstram que, a uma escala global, a diversidade de répteis (riqueza) mas não a abundância, diminui imediatamente após o fogo (<1 ano),mas recupera rapidamente para níveis anteriores ao fogo, com aumento da abundância. Em relação às cobras, o número de espécies não é significativamente afectada pelo tempo desde o último incêndio, mas a abundância diminui nos estádios mais tardios da sucessão ecológica. No Parque Natural da Serra da Estrela, a abundância de répteis diminui nos primeiros 5 anos após o fogo mas recupera entre os 5 e os 20 anos de sucessão ecológica. Também concluí que a abundância de Psammodromus algirus (a espécie mais abundante) está positivamente relacionada com a cobertura arbórea, e negativamente relacionada com a herbácea. A diversidade de plantas é também um parâmetro relevante para os répteis, já que a sua presença está positivamente relacionada com a diversidade de espécies de plantas. Relativamente à dieta, as redes ecológicas para as lagartixas recolhidas nos habitats ardidos e não ardidos, demonstraram que P. algirus apresenta uma dieta mais selectiva nas zonas não ardidas do que as ardidas. Também encontrei diferenças na disponibilidade de presas entre zonas ardidas e não ardidas. Os meus resultados sugerem que imediatamente após o fogo há um decréscimo da riqueza de espécies, mas as comunidades recuperam rapidamente e a abundância aumenta em estádios iniciais de sucessão ecológica (tanto a nível global, como no Parque Natural da Serra da Estrela). Embora os répteis representem uma relação próxima com a estrutura do habitat, parecem estar bem adaptados a áreas com diferente tempo desde o último incêndio e apresentam abundância estáveis ao longo da sucessão ecológica. Mais ainda, possuem variação da dieta e estão acostumados a consumir uma grande variedade de presas quando as condições não são as adequadas.There is an increasing recognition that fire is an important component of many ecosystems in the world, essential to understand the ecology and diversity of communities in fire-prone regions. It impacts fauna directly, through mortality, or indirectly by changing habitat structure and resources availability. In recent decades global warming, land abandonment and changes in traditional agricultural activities are driving changes in the frequency and extent of fires. In this context, to know the response of organisms to fire regimes is a conservation priority. Reptiles are a good model group to examine their responses to fire as they are ectothermic, sensible to modifications in habitat attributes such as vegetation structure and canopy closure, have low mobility and dispersal rates, and experience high rates of population declines and extinction. The purpose of this study is to evaluate the effects of fire on reptile assemblages at two geographic scales: at a worldwide scale, where I examined patterns of reptile responses to fire considering the time since fire effect with a meta-analysis methodology (Chapter 1); at a local scale, where I evaluated the effect of wildfires on the reptile communities of the Serra da Estrela Natural Park, namely on the population densities, species richness (Chapters 2) and examined how the trophic ecology and interspecific interactions varied with fire using the Psammodrome lizard as a model species (Chapter 3). For this, I used a set of proper methodologies in order to collect and analyze all the data needed to perform this study (search scientific data for a meta-analysis; transects for reptile surveys followed by vegetation and habitat structure characterization; fecal pellets analysis and network metrics for lizard‟s diet). At a worldwide scale, lizards‟ diversity (richness) but not abundance decreases immediately after fire (<1 year) but recovers quickly to pre-fire levels with increased abundance. Regarding snakes, diversity is not significantly affected by time-since-fire but abundance decreases in the latter stages of the post-fire succession. In Serra da Estrela Natural Park, reptile abundance decreases in the first 5 years of post-fire succession, but increases in the interval between 5-10 years. I also found that Psammodromus algirus is positively related with tree cover, and negatively related with herbaceous cover. Plant diversity is also a relevant parameter for reptiles, since its presence (abundance) is positively related with the diversity of plant species. Relatively to the diet, metrics of the bipartite network for lizards collected in unburned and burned habitats demonstrated that P. algirus presents more selective behaviors in unburned habitats, than in burned ones. I have also found differences between burned and unburned areas as regards availability of prey, being the burned area the one presenting the richest arthropod communities. My results suggest that immediately after fire there is a decrease in species richness but communities recover quickly and reptile abundance increases in early stages of post-fire succession (both globally, and also in Serra da Estrela Natural Park). Although reptiles present a close relation with habitat structure, they seem well adapted to areas with different time since fire and present stable abundances across the post-fire succession. Moreover, they have diet variation and are adapted to consume a large variety of preys when conditions are not suitable. In undisturbed areas, they may present a selective behavior

The Stand Up to Bullying (SU2B) Project: Participatory Action Research with Middle School Youth

The Stand Up to Bullying (SU2B) participatory action research project is presented as an approach to collaborative community action. The SU2B project, conducted in the United States, represents an interdisciplinary collaboration with two county agencies in the state of Maryland: the Local Management Board and the Board of Education.&nbsp; Over the course of six weeks, 78 middle school students participating in the SU2B project were trained to serve as anti-bullying ambassadors for their schools. Middle school students collaborated with undergraduate students enrolled in a community and applied social psychology course to conduct a photovoice component. Photovoice is a community empowerment and advocacy tool and qualitative research methodology in which people express their experiences with a social or community problem through photography. The middle school students took digital photographs in and around their school that they felt exemplified bullying. From the resultant photos, they selected two and wrote accompanying titles and descriptions, for display in a public art exhibit. Select photographs were subsequently converted into anti-bullying educational posters for display in county public schools. Additionally, photographs were augmented with interviewers with participants and project staff to create anti-bullying educational training videos for use in county public schools. Findings of bullying experiences with middle school students are discussed

The Stand Up to Bullying (SU2B) Project: Participatory Action Research with Middle School Youth

The Stand Up to Bullying (SU2B) participatory action research project is presented as an approach to collaborative community action. The SU2B project, conducted in the United States, represents an interdisciplinary collaboration with two county agencies in the state of Maryland: the Local Management Board and the Board of Education.&nbsp; Over the course of six weeks, 78 middle school students participating in the SU2B project were trained to serve as anti-bullying ambassadors for their schools. Middle school students collaborated with undergraduate students enrolled in a community and applied social psychology course to conduct a photovoice component. Photovoice is a community empowerment and advocacy tool and qualitative research methodology in which people express their experiences with a social or community problem through photography. The middle school students took digital photographs in and around their school that they felt exemplified bullying. From the resultant photos, they selected two and wrote accompanying titles and descriptions, for display in a public art exhibit. Select photographs were subsequently converted into anti-bullying educational posters for display in county public schools. Additionally, photographs were augmented with interviewers with participants and project staff to create anti-bullying educational training videos for use in county public schools. Findings of bullying experiences with middle school students are discussed

Il licenziamento disciplinare illegittimo

Dopo aver illustrato le dinamiche giuridiche che sovrintendono il sistema disciplinare, si cercherà di focalizzare l’attenzione sull’importanza primaria che riveste la funzione correttiva, ratio iuris delle sanzioni disciplinari stesse. In tale ottica si osserverà che la massima sanzione del licenziamento disciplinare costituisce un indefettibile deterrente psicologico nella commissione di ogni infrazione. Il funzionamento dell’istituto della recidiva, che contempla una risposta sanzionatoria in misura progressivamente più severa rispetto alla commissione della singola infrazione (in ragione della reiterazione degli illeciti disciplinari commessi) costituisce concreta ed esaustiva esemplificazione di quanto testé detto. L’attenzione verrà poi spostata sullo “speciale” automatismo previsto ex lege dell’estinzione del rapporto di lavoro - pur - a seguito di infrazioni sotto la soglia della “notevolezza”, evidenziandosi all’uopo che sostanzialmente esso presenta, quanto agli effetti prodotti, molte similitudini con il licenziamento disciplinare. Da ciò potrebbe discenderne la logica conseguenza che in questo modo possa essere stata (involontariamente) ingenerata nel lavoratore di “media intelligenza”, una loro sostanziale identica percezione punitiva, posto che entrambi le “formule” espulsive utilizzate dal legislatore possiedono comunque natura prettamente disciplinare. Pertanto, anticipando subito quanto riportato nelle note conclusive, si avanzerà l’ipotesi che la costruzione tecnico-giuridica di cui all’art. 3 D.lgs. 23/2015 (nonché quella della L. Fornero)- così come sono state strutturate - non permettano di poter escludere la possibilità che la succitata funzione correttiva possa essere seriamente compromessa. Specie riguardo al principio di proporzionalità tra infrazione commessa e sanzione irrogata

IT Career Counseling: Are Occupational Congruence and the Job Characteristics Model Effective at Predicting IT Job Satisfaction?

The IT industry struggles to attract qualified talent despite an exceptional outlook in terms of both job availability and compensation. Similarly, post-secondary academic institutions report difficultiesrecruitingstudents for IT majors. One potential reason for this is that current career counseling practices do not adequately convey relevant job characteristic data to prospective job applicants and academic majors. Accordingly, we report the results of a survey of72 IT professionals regarding their job interests and perceptions of important characteristics of their current job. We use the data to test the efficacy of Holland’s classic occupation congruence model, the basis of current career counseling practices.In addition, we assess an alternate congruence model based on professionals’job perceptions and the Job Characteristics Model of Work Motivation (JCM) to determine which is more effective at predicting desired job outcomes. Results show that a sub-set of JCM constructs including task variety, task identity, and task autonomy is superior to both congruence models in predicting positive job outcomes. This suggeststhat IT career counseling outcomes mightbe improved by emphasizingthe JCMcharacteristics

Retroperitoneal abscess with concomitant hepatic portal venous gas and rectal perforation: a rare triad of complications of acute appendicitis. A case report

<p>Abstract</p> <p>Background</p> <p>While retroperitoneal abscess is a known complication, hepatic portal venous gas and rectal perforation have not been reported as a concomitant sequelae of acute appendicitis. Here we report a case of a patient with a perforated appendicitis that was associated with these triad of complications.</p> <p>Materials and Methods</p> <p>In addition to report our case, we carefully reviewed the literature in order to detect similar cases and the causes of such rare conditions.</p> <p>Results</p> <p>Only 26 cases (including our patient) of acute appendicitis complicated by retroperitoneal abscesses have been published in the English literature between 1955 and 2008. There was one case having hepatic portal venous gas, and one further case with a rectal perforation associated with acute appendicitis. All patients with retroperitoneal abscess presented with non specific clinic symptoms that not revealed any suspicion for such a complicated disease. Hence, delayed diagnosis and treatment are not uncommon.</p> <p>Conclusions</p> <p>So far, no patient has been described with such a triad of rare complications related to acute appendicitis. We want to emphasize the insidious onset of retroperitoneal abscess formation, and the need of prompt recognition and adequate treatment to avoid deleterious outcome.</p